Healthcare Provider Details

I. General information

NPI: 1124538483
Provider Name (Legal Business Name): BRITTANY ANN WENZELL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2017
Last Update Date: 10/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22001 FAIRMOUNT BLVD
CLEVELAND OH
44118-4819
US

IV. Provider business mailing address

550 GLEN PARK DR
BAY VILLAGE OH
44140-2450
US

V. Phone/Fax

Practice location:
  • Phone: 216-932-2800
  • Fax:
Mailing address:
  • Phone: 440-897-3165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberRN.430098
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: